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Pancreatitis, Chronic

Mohammed Almamun, M. Sc. , M.D. and Mark Stephens, MD MS Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Chronic pancreatitis (CP) is a long-standing and progressive fibro-inflammatory syndrome of the pancreas due to toxic, metabolic, genetic, autoimmune, obstructive and idiopathic mech...

DIAGNOSIS

As with acute pancreatitis, symptoms do not always correlate well with objective findings (imaging, amylase/lipase). 

HISTORY

  • Epigastric pain, often radiating to the back

  • Flare-ups may mimic ac...

TREATMENT

GENERAL MEASURES

  • Discontinue tobacco and alcohol use.

  • Consider pain consultation

  • Exocrine and endocrine replacement therapy (enzymes and insulin)

MEDICATION

First Line

  • Discontinue alcohol and toba...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Follow fasting blood glucose, as the development of type 3 diabetes is most likely related to the duration of disease. 

  • There is no evidence to suggest that pancre...

REFERENCES

1
Capurso G, Tacelli M, Vanella G, et al. Managing complications of chronic pancreatitis: a guide for the gastroenterologist. Expert Rev Gastroenterol Hepatol. 2023;17(12):1267-1283. doi: 10...

ADDITIONAL READING

  • Nabi Z, Lakhtakia S. Endoscopic management of chronic pancreatitis. Dig Endosc. 2021;33(7):1059-1072. doi: 10.1111/den.13968. PMID: 33687105.

  • ...

SEE ALSO

Choledocholithiasis; Lupus Erythematosus, Systemic (SLE); Peptic Ulcer Disease; Substance Use Disorders 

CODES

ICD10

K86.1 Other chronic pancreatitis 
K86.0 Alcohol-induced chronic pancreatitis 

SNOMED

  • 235494005 Chronic pancreatitis (disorder)

  • 235952002 Alcohol-induced chronic pancreatitis (disorder)

  • 235954001...

CLINICAL PEARLS

  • Contrast-enhanced CT is the initial diagnostic test of choice in patients with suspected CP

  • Pain management is a central component in managing chronic pancreatitis.

  • Assess for exocrine p...

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